As I swapped to a 4070ti which uses less power than a 4090 (I'm guessing?) and the stutter still persisted I thought that would rule out the PSU but maybe that's worth a go as well?
I haven't looked at it, in awhile, but from what I can recall of the AMD fTPM issues, it spams the event log with errors and the stuttering tends to be intolerable, whereas what you're describing with the FPS drops is probably not the same.
I believe a hardware/external TPM does fix the issue though, for those that have it.
Have you tried a different monitor? I read the whole thread and didn't see that mentioned but sorry if I missed it. Or plug it into a TV you have in the house to confirm it's not an issue with your high refresh monitor which you are perceiving as stutter, which is in fact a monitor issue. Highly unlikely I'm sure but would take 2 minutes to test.
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